How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $120.23 Median $169.82 Typical High $4,365.16 | Facility | None | $120.23 | $169.82 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $199.53 | Professional | None | $102.33 | $151.36 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $131.83 Typical High $323.59 | Facility | None | $87.10 | $131.83 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $512.86 | Professional | None | $275.42 | $338.84 | $512.86 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $257.04 Typical High $549.54 | Facility | None | $169.82 | $257.04 | $549.54 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $446.68 Typical High $1,318.26 | Professional | None | $154.88 | $446.68 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $371.54 | Professional | None | $281.84 | $281.84 | $371.54 |
Midlands Setting Facility Modifier None Typical Low $87.10 Median $114.82 Typical High $154.88 | Facility | None | $87.10 | $114.82 | $154.88 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $354.81 | Professional | None | $257.04 | $257.04 | $354.81 |
Sanford Health Plan Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $331.13 | Professional | None | $177.83 | $245.47 | $331.13 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $144.54 Median $323.59 Typical High $467.74 | Professional | None | $144.54 | $323.59 | $467.74 |
Wellmark Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $446.68 | Professional | None | $218.78 | $269.15 | $446.68 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $60.26 Typical High $83.18 | Professional | 52 · Reduced service | $50.12 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $24.55 Typical High $33.11 | Professional | 53 · Discontinued | $20.42 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $91.20 Typical High $123.03 | Professional | 54 · Surgery only | $75.86 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.20 Typical High $24.55 | Professional | 55 · Aftercare only | $15.14 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.02 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.00 | $12.02 | $16.60 |
Where South Dakota sits
The same service costs 3.7 times more in Wisconsin than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
South Dakota· 7th of 51
$282
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.